Cause 7. Medications and Drugs: Unintended Consequences
Many types of medications and drugs, despite their therapeutic benefits, can sometimes lead to unintended consequences, one of which is cerebellar ataxia. This cause underscores the importance of a comprehensive understanding of not just the therapeutic actions of medications, but also their potential side effects, and emphasizes the necessity of open communication between healthcare providers and patients.
One group of medications that can lead to cerebellar ataxia are certain antibiotics. For instance, prolonged use of metronidazole, an antibiotic commonly used to treat various protozoan and anaerobic bacterial infections, has been reported to cause cerebellar dysfunction.
Symptoms of this neurotoxicity can include ataxia, dysarthria, and nystagmus, and are generally reversible after discontinuation of the drug. Another group of antibiotics, the fluoroquinolones, have also been associated with cases of cerebellar ataxia. Although rare, this potential side effect underscores the importance of vigilance when prescribing and using these drugs.
Antiepileptic medications, another key group, can also induce cerebellar ataxia. Phenytoin, for instance, used widely in the management of seizures, can cause cerebellar atrophy and resulting ataxia if used in high doses or over an extended period.
Similarly, barbiturates, another class of antiepileptic drugs, can lead to ataxia as a side effect. The risk and manifestation of ataxia can depend on the dosage, the duration of treatment, and individual patient factors.
Chemotherapy drugs, although lifesaving in many cases, can have neurotoxic effects leading to cerebellar ataxia. Platinum-based drugs such as cisplatin, used in the treatment of various cancers, can lead to peripheral neuropathy and cerebellar ataxia.
5-fluorouracil, another chemotherapeutic agent, has also been associated with a syndrome of acute cerebellar ataxia. The potential for these effects necessitates careful monitoring of patients undergoing chemotherapy and underscores the importance of balancing treatment efficacy with quality of life. (7)
